Risk Factors for Relapse and/or Prolonged Glucocorticoid Therapy in Polymyalgia Rheumatica: Multicenter Study in 185...

Area of Science:

• Rheumatology
• Clinical Medicine
• Pharmacology

Background:

• Polymyalgia rheumatica (PMR) frequently involves relapses and long-term glucocorticoid (GC) dependence.
• Identifying risk factors for PMR relapses and prolonged GC therapy is crucial for patient management.

Purpose of the Study:

• To assess risk factors associated with higher relapse rates and/or prolonged glucocorticoid therapy in polymyalgia rheumatica (PMR) patients.

Main Methods:

• A multicenter, observational chart review study included 185 PMR patients with at least a 3-month follow-up after initiating GCs.
• Cox proportional analysis was used to compare relapse and non-relapse groups, reporting hazard ratios (HRs) with 95% confidence intervals (CIs).

Main Results:

• A history of dyslipidemia was associated with a lower risk of relapse (HR, 0.54; 95% CI, 0.32-0.92; p = 0.023).
• High-dose GCs (HR, 2.46; 95% CI, 1.49-4.08; p = 0.001) were identified as a significant risk factor for relapse in multivariate analysis.
• Faster GC dose reduction also correlated with a higher risk of relapse (HR, 3.04; 95% CI, 1.77-5.21; p = 0.001).

Conclusions:

• Lower initial GC doses and a slower rate of dose reduction are critical for preventing PMR relapses.
• Therapeutic management, rather than initial clinical characteristics, appears to be the primary determinant of higher relapse rates in PMR.